Switching the nucleoside reverse transcriptase inhibitor backbone to tenofovir disoproxil fumarate + emtricitabine promptly improves triglycerides and low-density lipoprotein cholesterol in dyslipidaemic patients.

Marc Antoine Valantin 1, 2 Randa Bittar 3 Pierre De Truchis 4 D. Bollens L. Slama P. Giral D. Bonnefont-Rousselot P. Pétour C. Aubron-Olivier D. Costagliola C. Katlama Luc De Saint Martin 5, 6 Marie-Louise Guenegues 7
1 Service des maladies infectieuses et tropicales [CHU Pitié-Salpêtrière]
2 Epidémiologie, stratégies thérapeutiques et virologie cliniques dans l'infection à VIH
3 APHP - PSL - Département de Biochimie
4 AP-HP Hôpital Raymond Poincaré [Garches]
5 GETBO - Groupe d'Etude de la Thrombose de Bretagne Occidentale
6 DMIP - Brest - Département de Médecine Interne et Pneumologie [Brest]
7 CIC - Brest - Centre d'Investigation Clinique
Abstract : OBJECTIVES: To assess the impact of switching to tenofovir disoproxil fumarate + emtricitabine on lipid parameters. METHODS: HIV-infected patients with plasma viral load <400 copies/mL, fasted triglycerides from 2.3 to 11.4 mmol/L and/or fasted low-density lipoprotein (LDL)-cholesterol >4.1 mmol/L were randomized to switch the nucleoside reverse transcriptase inhibitor (NRTI) backbone to fixed-dose combination tenofovir disoproxil fumarate + emtricitabine or to maintain the baseline antiretroviral regimen (the control group). The study has been registered with ClinicalTrials.gov under the identifier NCT00323492. RESULTS: Ninety-one patients were included in the intent-to-treat (ITT) analysis with triglycerides 2.4 mmol/L and LDL-cholesterol 4.0 mmol/L (median values). At week 12, the median changes from baseline of triglycerides were -0.5 mmol/L (-25%; n = 46) and -0.1 mmol/L (-6%; n = 45) in the tenofovir disoproxil fumarate + emtricitabine and control groups, respectively, indicating a difference of -0.4 mmol/L (P = 0.034) [95% confidence interval (CI): -0.9 to -0.0]. Similarly for LDL-cholesterol, changes of -0.4 mmol/L (-9%) and -0.1 mmol/L (-1%) were observed in the tenofovir disoproxil fumarate + emtricitabine and control groups, respectively, indicating a difference of -0.4 mmol/L (P = 0.031) [95% CI: -0.7 to -0.0]. The proportion of patients with LDL-cholesterol >4.1 mmol/L decreased from 48% at baseline to 26% at week 12 in the tenofovir disoproxil fumarate + emtricitabine group versus no change in the control group. No virological failure was observed during the study. CONCLUSIONS: Switching to tenofovir disoproxil fumarate + emtricitabine in dyslipidaemic HIV-infected patients improves triglycerides and LDL-cholesterol.
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Journal of Antimicrobial Chemotherapy, Oxford University Press (OUP), 2010, 65 (3), pp.556-61. 〈10.1093/jac/dkp462〉
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Soumis le : mardi 19 février 2013 - 14:13:30
Dernière modification le : lundi 30 avril 2018 - 12:22:03

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Marc Antoine Valantin, Randa Bittar, Pierre De Truchis, D. Bollens, L. Slama, et al.. Switching the nucleoside reverse transcriptase inhibitor backbone to tenofovir disoproxil fumarate + emtricitabine promptly improves triglycerides and low-density lipoprotein cholesterol in dyslipidaemic patients.. Journal of Antimicrobial Chemotherapy, Oxford University Press (OUP), 2010, 65 (3), pp.556-61. 〈10.1093/jac/dkp462〉. 〈hal-00790099〉

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